Cooperative Health Insurance Law

Purpose and scope

• Aims to provide and organise health care for all non-Saudi residents, and may be extended to citizens and others by Council of Ministers decision (Article 1); cover includes family members as set by the Council (Article 2).
• The Council of Health Insurance supervises its application, qualifies insurers and accredits health facilities (Article 5).

Key rules, rights and obligations

• Every sponsor of a resident must insure that resident, and residence is issued or renewed only with a policy covering its period (Article 3).
• A resident not under work sponsorship takes the employer's place in these obligations (Article 15).
• Firms owning qualified private medical facilities may be exempted for the services they give their staff (Article 13).

Violations, penalties and common problems

• An employer who fails to insure or pay premiums must pay them all plus a fine of up to one year's premium per person, and may be barred from recruitment temporarily or permanently (Article 14 as amended).
• An insurer that breaches its policy obligations must perform them and compensate the damage, plus a fine of up to five thousand riyals per insured person affected (Article 14 as amended).
• Common problems: refusal to approve covered treatment, a policy expiring before the residence permit, and family members left uncovered.

Procedures and key deadlines

• A multi-agency committee hears violations and proposes the sanction, which the Council's chairman imposes; it may be challenged before the competent judicial body within sixty days of notification (Article 14 as amended).
• Beneficiaries should keep the policy, the benefits table and any written refusal, and complain through the Council of Health Insurance channels.

An advisory summary prepared by Al-Bayan Al-Wadih Law Firm. It is not an official text and does not replace the law, its implementing regulations, or advice from a specialised lawyer. The official published text and its amendments prevail.